Mendocino County Sheriff's Office

Welcome! This is an official application for a California Concealed Carry Weapon license. You must completely and accurately fill-out this application to be considered for a Concealed Carry Weapon License. Any falsification of the information within this application is a crime and will result in the denial of the applicant’s Concealed Carry Weapon license request.

Authority

California Penal Code sections 26150 and 26155 provide that a Sheriff of a county or the Chief or other head of municipal police department of any city, or city and county, shall issue or renew a license to carry a pistol, revolver, or other firearm capable of being concealed upon the person (Concealed Carry Weapon license).

 

Prior to Filling Out This Application

  • Be prepared to scan a copy of your valid California driver’s license, or state issued ID, which has your current address in Mendocino County.
  • Be prepared to scan copies of documents to verify proof of residency on request.

 

Please be advised that if you are applying for a RENEWAL, you will enter your current Local Agency Number in the Permit # field below.

Please be advised if you are applying for a MODIFICATION, and in order to add/delete a weapon, you must upload your qualification certificate via the Order Tracker upon completion of the application.

Please read the following before proceeding:

Applicant Information:


Spouse Information:


Previous Names/Aliases: (please list all previous aliases)

Previous Last Name Previous First Name Previous Middle Name City Where Changed State Court File #

**REQUIRED** - Please add 3 references: At least one of the 3 must be your cohabitant, if applicable.

Title Last Name First Name Middle Name Address City State Zip Phone Number Email Relationship  

Driver's License / Non-Operator ID: (or other State Issued ID)


Information Related To Your Birth:



Current Military Status:

Please bring in your DD214 with you for the appointment. If you were dishonorably discharged, you will be denied.

Demographic Information:


feet inches

Telephone Number: (###-###-####)


Email:


Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)


Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:
  • The password must be a minimum length of eight (8) characters on all systems
  • The password must not be a dictionary word
  • The password must not be the same as your email address
  • The password must not be a proper name

Current Residence Address: (this may be different than your mailing address)


Present Mailing Address: (if different from residence address)


Spouse Residence Address:


Time At Present Address:


Additional Residency Information:


Previous Addresses: (please list all previous addresses within the last 5 years)

Address Line 1 Address Line 2 City State Zip Country From To

Employment Status:


Work Information And Address: (enter your place of employment)


Occupation Field:

Please indicate your current occupation field. Enter unemployed if you currently do not have a job.


You must enter ALL the firearms you want to appear on your CCW license: Max of 3

Make Model Caliber Serial Number

Attach Documentation: please upload the required documentation

If you need to upload documentation, please use the button below to begin the process. The maximum size of individual files is 5 MB.
  • Valid government issued photo ID (ex. Passport, CA Drivers/State ID)
  • Proof of Residency (2 items): utility bill, property tax, credit card bill, vehicle registration, voter registration
  • Mendocino County approved Qualification Certificate (optional, min 16 hour)

Uploaded Files:

Add files...
Please select a document type then, click on the “Attach” button to complete the upload process.

Select Your Application Type:



Total Fee:

$0

I accept and assume all responsibility and liability for, injury to, or death of any person, or damage to any property which may result through an act or omission of either the licensee or the agency that issued the license. In the event any claim, suit or action is brought against the agency that issued the license, its chief officer or any of its employees, by reason of, or in connection with any such act or omission, the licensee shall defend, indemnify, and hold harmless the agency that issued the license, its chief officer or any of its employees from such claim, suit, or action.

I understand that the acceptance of any application by the licensing authority does not guarantee the issuance of a license and that fees and costs are not refundable if denied. I further understand that if my application is approved and I am issued a license to carry a concealed weapon, that the license is subject to restrictions placed upon it and that misuse of the license will cause an automatic revocation and possible arrest and that the license may also be suspended or revoked at the discretion of the licensing authority at any time. I am aware that any use of a firearm may bring criminal action or civil liability against me.

I have read, understand, and agree to the CCW license liability clauses, conditions, and restrictions stated in this application and Agreement to Restrictions and to Hold Harmless.

I have read and understand the applicable Penal Code sections regarding false statements on a CCW Application, manslaughter, killing in defense of self or property, limitation on self-defense and defense of property, and child access and firearm storage, stated in this application.

I have read and understand the Firearms Prohibiting Categories attachment to this application. I further acknowledge that these prohibiting categories can be amended or expanded by state or federal legislative or regulatory bodies and that any such amendment or expansion may affect my eligibility to hold a CCW license.

I herby give permission to the agency to which this application is made to conduct a background investigation of me and to contact any person or agency who may add to or aid in this investigation. I further authorize persons, firms, agencies and institutions listed on this application to release or confirm information about me and statements I have made as contained in this application.

Notwithstanding any other provision of law and pursuant to the Public Records Act (Government Code section 6250 et seq.), I understand that information contained in this application may be a matter of public record and shall be made available upon request or court order. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Please enter your e-Signature



For security purposes, we logged your IP Address: 3.145.45.223, 162.158.78.57:10962, 40.1.2.126
User's Signature

Application Qualification Questions:

Do you now have, or have you ever had, a license to carry a concealed weapon (CCW)? If yes, please enter the issuing agency name, issue date and CCW license number.

Have you ever applied for and been declined a CCW license?

Have you ever held and subsequently renounced your United States citizenship?

Have you ever been charged with any criminal offense (civilian or military) in the United States or any other country, even if such charges were dismissed?

Have you ever been detained or arrested in the United States or any other country?

Are you now, or have you been, on probation, parole, post release community supervision, or mandatory supervision from any state for conviction of any offense including traffic?

Are you now, or have you been, a party to a lawsuit in the last five years?

If you served with the Armed Forces, was your discharge other than honorable?

 

Are you now, or have you been subject to any restraining order, protective order, or other type of court order issued, prusuangt to Penal Code section 646.91 (stalking); Part 3, commencing with section 6240, or Part 4, commencing with section 6300, of Division 10 of the Family Code (domestic violence or abuse); Penal Code section 136.2 (victims and witnesses of crime); Penal Code section 18100 (gun violence restraining order); Code of Civil Procedure section 527.6 (civil harassment); Code of Civil Procedure section 527.8 (workplace violence); Code of Civil Procedure section 527.85 (school violence); Welfare and Institutions Code sections 213.5, 304, 362.4, or 726.5 (juvenile court orders); or Welfare and Institutions Code section 15657.03 (elder/dependent adult abuse)?

Are now, or have you been, subject to a valid restraining, protective, or stay-away order issued by an out-of-state jurisdiction pursuant to laws concerning domestic violence, family law, protection of children or elderly persons, stalking, harassment, witness intimidation, or firearm possession?

Are you now, or have you been, subject to a valid restraining, protective, or stay-away order issued by any court within the United States or by any out-of-state jurisdiction?

List all traffic violations (moving violations only) and motor vehicle accidents you have had in the last five years.

Have you ever been taken into custody as a danger to self or others for reasons related to mental health under Welfare and Institutions Code sections 5150 or 5585, or assessed under Welfare and Institutions Code Section 5151, or admitted to a mental health facility under Welfare and Institutions Code sections 5150 or 5152, or certified for mental health treatment under Welfare and Institutions Code sections 5250, 5260, or 5270.15?

Have you ever otherwise been treated for mental illness?

Have you ever been found not guilty by a reason of insanity or mentally incompetent to stand trial?

Are you now, or have you ever been, addicted to a controlled substance of alcohol, or have you ever utilized an illegal controlled substance, or have you ever reported to a detoxification or drug treatment program?

Have you engaged in an unlawful or reckless use, display, or brandishing of a firearm?

Have you ever been involved in an incident involving firearms?

Have you ever been involved in a domestic violence incident?

Have you withheld any fact that might affect the decision to approve this license?

Have you ever lost a firearm, or had a firearm stolen?

Please list all restrictions on your driver's license.


I accept and assume all responsibility and liability for, injury to, or death of any person, or damage to any property which may result through an act or omission of either the licensee or the agency that issued the license. In the event any claim, suit or action is brought against the agency that issued the license, its chief officer or any of its employees, by reason of, or in connection with any such act or omission, the licensee shall defend, indemnify, and hold harmless the agency that issued the license, its chief officer or any of its employees from such claim, suit, or action.

I understand that the acceptance of any application by the licensing authority does not guarantee the issuance of a license and that fees and costs are not refundable if denied. I further understand that if my application is approved and I am issued a license to carry a concealed weapon, that the license is subject to restrictions placed upon it and that misuse of the license will cause an automatic revocation and possible arrest and that the license may also be suspended or revoked at the discretion of the licensing authority at any time. I am aware that any use of a firearm may bring criminal action or civil liability against me.

I have read, understand, and agree to the CCW license liability clauses, conditions, and restrictions stated in this application and Agreement to Restrictions and to Hold Harmless.

I have read and understand the applicable Penal Code sections regarding false statements on a CCW Application, manslaughter, killing in defense of self or property, limitation on self-defense and defense of property, and child access and firearm storage, stated in this application.

I have read and understand the Firearms Prohibiting Categories attachment to this application. I further acknowledge that these prohibiting categories can be amended or expanded by state or federal legislative or regulatory bodies and that any such amendment or expansion may affect my eligibility to hold a CCW license.

I herby give permission to the agency to which this application is made to conduct a background investigation of me and to contact any person or agency who may add to or aid in this investigation. I further authorize persons, firms, agencies and institutions listed on this application to release or confirm information about me and statements I have made as contained in this application.

Notwithstanding any other provision of law and pursuant to the Public Records Act (Government Code section 6250 et seq.), I understand that information contained in this application may be a matter of public record and shall be made available upon request or court order. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

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I accept and assume all responsibility and liability for, injury to, or death of any person, or damage to any property which may result through an act or omission of either the licensee or the agency that issued the license. In the event any claim, suit or action is brought against the agency that issued the license, its chief officer or any of its employees, by reason of, or in connection with any such act or omission, the licensee shall defend, indemnify, and hold harmless the agency that issued the license, its chief officer or any of its employees from such claim, suit, or action.

I understand that the acceptance of any application by the licensing authority does not guarantee the issuance of a license and that fees and costs are not refundable if denied. I further understand that if my application is approved and I am issued a license to carry a concealed weapon, that the license is subject to restrictions placed upon it and that misuse of the license will cause an automatic revocation and possible arrest and that the license may also be suspended or revoked at the discretion of the licensing authority at any time. I am aware that any use of a firearm may bring criminal action or civil liability against me.

I have read, understand, and agree to the CCW license liability clauses, conditions, and restrictions stated in this application and Agreement to Restrictions and to Hold Harmless.

I have read and understand the applicable Penal Code sections regarding false statements on a CCW Application, manslaughter, killing in defense of self or property, limitation on self-defense and defense of property, and child access and firearm storage, stated in this application.

I have read and understand the Firearms Prohibiting Categories attachment to this application. I further acknowledge that these prohibiting categories can be amended or expanded by state or federal legislative or regulatory bodies and that any such amendment or expansion may affect my eligibility to hold a CCW license.

I herby give permission to the agency to which this application is made to conduct a background investigation of me and to contact any person or agency who may add to or aid in this investigation. I further authorize persons, firms, agencies and institutions listed on this application to release or confirm information about me and statements I have made as contained in this application.

Notwithstanding any other provision of law and pursuant to the Public Records Act (Government Code section 6250 et seq.), I understand that information contained in this application may be a matter of public record and shall be made available upon request or court order. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

If you are paying cash or check, please show up 15 mins early for your appointment to accommodate processing your payment.
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